Only 11 Percent of Reimbursement Tied to Value

Only 11 percent of commercial health care payments to doctors and hospitals is tied to performance or designed to cut waste, according to a new National Scorecard on Payment Reform by Catalyst for Payment Reform (CPR). By comparison, 89 percent of payments are made through payment methods that do not have a quality or other performance components and the traditional fee-for-service system.

Among payments tied to value, just 60 percent involve providers taking on a share of the risk, meaning they stand to lose money if they do not meet certain quality and efficiency measures or exceed a budget. The rest are in programs such as pay-for-performance, which offer incentives for providing high-quality care, but do little to discourage overuse or inappropriate care.

CPR, an employer-founded nonprofit focused on creating greater value in healthcare, has a goal of having at least 20 percent of health care payments will be value-oriented by the year 2020.

Posted in Finance, Hospitals, Physicians.